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- Results-driven Leader possessing a broad knowledge of Worker s Compensation claims processing.
- Recognized for strong problem-solving skills with an ability to increase efficiency and resolve issues in a timely manner.
- Excellent interpersonal communication skills, key to establishing rapport / trust and maintaining positive relationships.
- Consistently achieved and exceeded set objectives / goals.
Sedgwick Juris System
ISO Claim Search System
MS Office Suite
Delta Associated Investigation, Inc., Buford, GA 2015-2017
- Fulfilled key leadership position within an agency responsible for conducting fraud investigations and background checks.
- Used strong leadership skills to conduct in-depth training for Case Managers.
- Formed positive relationships with clientele; maintained detailed client records and handled special requests.
- Leveraged strong communication skills to serve as a liaison between Adjusters and Case Managers; simplified complex claims concepts.
- Provided direct support to Human Resources Director and Case Managers in various capacities.
- Strengthened existing industry knowledge by completing continuing education courses.
- Thoroughly reviewed data to ensure quality control throughout all operations; created daily log to ensure correct alignment of Investigators and cases.
- Properly delegated cases to Investigators; compiled pertinent information.
- Responsible for handling various financial operations, including collection of unpaid bills and accounts receivable issues.
- Demonstrated an ability to interact cohesively with executive team.
Law offices of Humberto Izquierdo, Jr. Esq., Cumming, GA 2013-2015
- Successfully handled claims across 3 states; conducted in-depth interviews, compiled data and educated clients on Worker s Compensation / insurance processes.
- Used strong leadership skills to conduct training for Legal Assistants.
- Increased case load from 60 pending Worker s Compensation files to 200+; independently maintained 40+ files.
- Contributed extensively to record-breaking collection of $1M+ in annual legal fees.
- Properly filed associated documents with appropriate state entities.
- Conducted in-depth legal research, as well as extensive interviews with industry experts.
- Maintained open lines of communication with Insurance Adjuster.
- Responsible for trial preparation; successfully compiled information, prepared motions, drafted demand letters and created settlement proposals / statements.
- Demonstrated strong organizational skills while maintaining detailed medical records and billing information.
- Performed on-site inspections of vehicles.
FCCI Insurance Group 2011-2015
Senior Claim Examiner- Field Adjuster
- Fulfilled key investigation role, compiled claimant information and thoroughly reviewed data to verify coverage.
- Exceeded objectives by 135%; successfully assigned 152 claims within a 12-month period while maintaining a quality audit score of 90%+.
- Attended mediations and depositions; properly recorded and submitted key information
- Maintained adherence to all regulations.
- Appropriated assigned claims to Broker and defense counsel; used strong legal knowledge to provide recommendations regarding claims resolution.
- Educated employees on Worker s Compensation process.
Sedgwick Claim Management Services; Senior Claim Examiner III - Kroger Account 2010-2011
AIG Domestic Claims-Chartis Insurance Company; National Accounts Claims Adjuster 2004-2010
Travelers Insurance Co., Alpharetta, GA; Claims Resolution Adjuster 1992-2003
Worker s Compensation License, State of Georgia
John Maxwell s Leadership Conference in Orlando Florida
Accounting Coursework Completed, Georgia State University, Atlanta, GA
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